Clinical Implications of Intraventricular Hemorrhage

Intracerebral hemorrhage (ICH) is a devastating form of stroke. Several predictors of poor outcome have been identified, including intraventricular hemorrhage (IVH). In a cohort of 406 patients with ICH, these authors retrospectively examined the relation between location and volume of ICH and the presence of IVH. They also tested the hypothesis that IVH might actually be beneficial, if it provides spontaneous ICH decompression into the ventricle.

In addition to identifying ICH and IVH location and volume, the authors calculated a decompression range for each location of ICH; that is, the range of ICH volume below which IVH was rare and above which IVH was almost universal. The authors hypothesized that decompression into the ventricle may reduce parenchymal hemorrhage volume.

IVH was more common in patients with larger volumes of ICH and with ICH in certain brain regions. Patients with IVH were more likely to have poor outcomes. Spontaneous ventricular decompression (IVH and ICH volume in the lower half of the decompression range) was not associated with better outcomes compared with no spontaneous decompression (no IVH despite ICH volume in the upper half of the decompression range). The authors conclude that their results are consistent with prior studies that demonstrated the important prognostic value of IVH volume.